anti-thymocyte globulin + mycophenolate mofetil + steroids

This entry describes the induction and initial maintenance immunosuppressive regimen used in the SIRES clinical trial (NCT01530165), led by investigator Josep M. Grinyó. The regimen is a combination of rabbit anti-thymocyte globulin (Thymoglobulin), mycophenolate mofetil, and corticosteroids. Thymoglobulin acts as a T-cell depleting agent, while mycophenolate mofetil inhibits inosine monophosphate dehydrogenase (IMPDH) to prevent lymphocyte proliferation. Corticosteroids provide broad immunosuppression via glucocorticoid receptor activation. This specific combination was administered pre-transplant and in the immediate post-operative period to kidney transplant recipients. The trial's primary goal was to use pre-transplant ELISPOT donor-specific T-cell reactivity to personalize subsequent maintenance therapy, specifically evaluating the safety of a calcineurin inhibitor (CNI)-free sirolimus-based regimen in low-reactivity patients.

Brand names

ThymoglobulinCellCept

Other names

PRE-TRANSPLANT (SIRES trial)ELISPOT-guided induction regimen